Search PubMed⌕ Search

Biomedical subjects

E Tolosa

Publications and source records attributed to E Tolosa.

At least 181 records · Page 10Linked to original sources

Giant-cell arteritis presenting with ipsilateral hemiplegia and lateral medullary syndrome.

We describe the clinical and anatomopathological findings in an 85-year-old male presenting with a lateral medullary syndrome and ipsilateral hemiplegia (Opalski's syndrome) due to giant-cell arteritis of the vertebral artery. Other common associated symptoms of the disease were absent, and the erythrocyte sedimentation rate was only of 30 mm/h. This case emphasizes that limited intracranial giant-cell arteritis may present rarely as a stroke.

Aged↗

[Hemangioma of the vertebrae: contribution of magnetic resonance to its study].

Vertebral hemangioma is a benign vascular tumor predominantly involving the dorsolumbar spine. Although most of these tumors are asymptomatic, they may result in radiculopathy and/or compressive myelopathy. Plain X-ray films and computed tomography (CT) generally permit the diagnosis by showing characteristic images with hypertrophic bone trabeculation in the vertebral body. We report three patients with vertebral hemangioma in which CT was diagnostic. Magnetic resonance (MR) with low intensity field was inferior to CT for the suggestion of the diagnosis of hemangioma, but had a better definition for subarachnoid space obliteration and spinal cord compression.

Adult↗

Blink reflex studies in focal dystonias: enhanced excitability of brainstem interneurons in cranial dystonia and spasmodic torticollis.

We have studied the orbicularis oculi reflex to paired stimuli in patients with various forms of focal dystonia and in normal controls. In normals, the conditioning stimulus (CS) facilitated the test stimulus (TS) early response (R1), but markedly inhibited the TS polysynaptic late response (R2). In all types of dystonias studied the CS facilitated the TSR1 as in normals. However, in patients with blepharospasm (alone or associated with oromandibular dystonia), spasmodic torticollis, or spasmodic dysphonia, it inhibited the TSR2 significantly less than that of the controls, with marked enhancement of the recovery curve of the late response. The TSR2 recovery curve of patients with focal arm dystonia was normal. These results are indicative of increased brainstem interneuron excitability in the various dystonias mediated by the cranial nerves, but not in focal arm dystonias such as dystonic writer's cramp. This abnormality might be caused by an abnormal input possibly from the basal ganglia upon these brainstem cells. Our results also suggest that a similar pathophysiology underlies the various focal dystonias of the head and neck.

Blepharospasm↗

Meige syndrome: neuropathology of a case.

Primary Meige syndrome is a form of cranial dystonia of unknown cause. Only three postmortem studies have been reported, and the results of these studies have not been consistent. We have examined the brain of a 72-year-old man with typical primary Meige syndrome and found mild to moderate cell loss in the zona compacta of the substantia nigra, locus ceruleus, midbrain tectum, and dentate nucleus of the cerebellum. Also frequent Lewy bodies were present in pigmented nuclei of the brainstem. No abnormalities were detected elsewhere. These pathological findings support the notion that brainstem pathology is important in the pathophysiology of cranial dystonia.

Aged↗

Selective concentration of anti-Purkinje cell antibody in the CSF of two patients with paraneoplastic cerebellar degeneration.

An anti-Purkinje cell antibody (APCA) was found in serum and CSF of 2 patients with paraneoplastic cerebellar degeneration (PDC) and breast carcinoma. Integrity of the blood-brain barrier (BBB) was normal in one patient and slightly damaged in the other. In both patients CSF IgG index was normal, but CSF/serum APCA ratio and CSF IgG APCA index were elevated suggesting that a selective concentration of the APCA in CSF occurs in patients with PCD. This feature supports the hypothesis that APCA may play a role in the pathogenesis of PCD.

Adult↗

Blepharospasm-oromandibular dystonia syndrome (Meige's syndrome): clinical aspects.

Meige's syndrome is a form of cranial dystonia characterized by the presence of bilateral dystonic spasms of the facial muscles and frequently of other cranial muscles as well. Its most common and disabling manifestation is blepharospasm which can render the patient functionally blind. Several types of orbicularis oculi spasms occur in Meige's syndrome: brief clonic spasms, prolonged dystonic spasms, constant tonic contraction, and "apraxia" of lid opening. In the completed form of the syndrome, blepharospasm is typically associated with lower facial or oromandibular dystonia. Spasms of the neck and limb muscles, generally mild, and action tremor not uncommonly accompany the cranial dystonia. In most patients the cause of the spasms is unknown. This so-called idiopathic or primary form of Meige's syndrome is considered an adult form of adult onset dystonia. Secondary Meige's syndrome can be encountered in the context of several neurodegenerative disorders, chronic administration of neuroleptics, levodopa, or other drugs, and in patients with focal brain lesions. These secondary cases of Meige's syndrome suggest that a dysfunction of the basal ganglia or of the mesencephalic/diencephalic region plays an important role in the pathophysiology of this dystonic syndrome. Recent neurophysiologic studies and postmortem findings in some patients also support the notion that disease of the brain stem contributes to the pathophysiology of orofacial dystonia.

Basal Ganglia Diseases↗

Transient immunologic defect in a case of Listeria rhombencephalitis.

We report a case of Listeria rhombencephalitis in a previously healthy 60-year-old man. Listeria rhombencephalitis is a rare but well-defined clinical syndrome of lower brain-stem involvement caused by Listeria monocytogenes. Contrary to other listerioses, rhombencephalitis has been mainly observed in patients without predisposing conditions. In our case, however, findings of a detailed immunologic study, performed three months and one year, respectively, after clinical onset of Listeria rhombencephalitis manifestations, showed a transient cellular immunity defect, not associated with any other apparent disease.

Encephalitis↗

Low-dose bromocriptine in the early phases of Parkinson's disease.

The effect of bromocriptine at doses up to 20 mg/day was studied in a single-blind format with a placebo phase in 15 Parkinson's disease patients with mild-to-moderate disability who had not been previously treated with levodopa. For the 11 patients who completed the 9 month trial, both Northwestern University Disability Scale and Columbia University Rating Scale scores were significantly reduced during bromocriptine therapy, when compared with either baseline or placebo scores. Two patients improved greater than 50% and had no side effects. Transient side effects appeared in four patients. Bromocriptine at doses of 20 mg/day or below may yield effective symptomatic improvement in de novo parkinsonism and may be considered as the initial treatment in young parkinsonian patients with only mild-to-moderate disability.

Adult↗

Parkinson's disease with depression: a possible subgroup of idiopathic parkinsonism.

We investigated the prevalence of mental depression (MD) in 34 patients with Parkinson's disease (PD) of recent onset, not receiving dopaminergic drugs, and in 23 healthy individuals of comparable age and sex. In the patients, dysthymic disorder and major depression were more common than in controls (p = 0.017). The severity of MD and PD were unrelated. In 15 patients, MD began before the symptoms of PD (mean, 5 years). These patients were younger, less impaired, and with a higher positive family history of PD. MD-associated PD may be a specific subgroup of PD.

Aged↗